All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional. If you are a patient or carer, please visit Know AML.
The aml Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the aml Hub cannot guarantee the accuracy of translated content. The aml and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.
The AML Hub is an independent medical education platform, sponsored by Astellas, Daiichi Sankyo, Johnson & Johnson, Kura Oncology and Syndax, and has been supported through educational grants from Bristol Myers Squibb and the Hippocrate Conference Institute, an association of the Servier Group. The funders are allowed no direct influence on our content. The levels of sponsorship listed are reflective of the amount of funding given. View funders.
Now you can support HCPs in making informed decisions for their patients
Your contribution helps us continuously deliver expertly curated content to HCPs worldwide. You will also have the opportunity to make a content suggestion for consideration and receive updates on the impact contributions are making to our content.
Find out moreCreate an account and access these new features:
Bookmark content to read later
Select your specific areas of interest
View AML content recommended for you
In adult Acute Myeloid Leukemia (AML) patients, the presence of Monosomal Karyotype (MK) is associated with adverse prognosis. However, the prognostic significance of isolated or combined occurrence of MK with Complex Karyotype (CK), Hypodiploid Karyotype (HK), and trisomy 8 in pediatric AML patients is not very clear.
In an article published in Leukemia on 25th April 2017, Mareike Rasche from the University Hospital of Essen, Essen, Germany, and colleagues discussed results from their study, which evaluated the prognostic impact of defined chromosomal aberrations in pediatric AML patients treated in the AML-Berlin-Frankfurt-Münster (BFM) 04 study (a randomized trial comparing liposomal daunorubicin with idarubicin as induction for pediatric AML [NCT00111345]).1,2
In total, 764 de novo AML pediatric patients (0–18 years) treated between March 2004–March 2012 according to the AML-BFM 04 study protocol were enrolled in this study. Cytogenetic data were available for 642 patients excluding patients with t(15;17)(PML-RARA fusion gene).
In summary, MK is a “strong and independent” prognostic factor for poor outcomes in pediatric AML patients. Additionally, HK without t(8,21) and trisomy 8 alone is associated with abysmal outcomes in pediatric AML patients.
The authors concluded by suggesting that their findings should be validated in an “independent patient cohort”, which could be important for risk stratification in pediatric AML patients.
We conducted a cytogenetic analysis of 642 children with de novo acute myeloid leukemia (AML) treated on the AML-Berlin-Frankfurt-Münster (BFM) 04 protocol to determine the prognostic value of specific chromosomal aberrations including monosomal (MK+), complex (CK+), and hypodiploid (HK+) karyotypes, individually and in combination. Multivariate regression analysis identified in particular MK+ (n=22) as a new independent risk factor for poor event-free survival (EFS; 23±9% vs 53±2% for all other patients, P=0.0003), even after exclusion of four patients with monosomy 7 (EFS 28±11%, P=0.0081). CK+ patients without MK had a better prognosis (n=47; EFS 47±8%, P=0.46) than those with MK+ (n=12; EFS 25±13%, P=0.024). HK+ (n=37, EFS 44±8% for total cohort, P=0.3) influenced outcome only when t(8;21) patients were excluded (remaining n=16, EFS 9±8%, P<0.0001). An extremely poor outcome was observed for MK+/HK+ patients (n=10, EFS 10±10%, P<0.0001). Finally, isolated trisomy 8 was also associated with low EFS (n=16; EFS 25±11%; P=0.009). In conclusion, monosomal karyotype is a strong and independent predictor for high-risk pediatric AML. In addition, isolated trisomy 8 and hypodiploidy without t(8;21) coincide with dismal outcome. These results have important implications for risk stratification and should be further validated in independent pediatric cohorts.
References